{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:08:50Z","timestamp":1766167730245,"version":"3.48.0"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Ulm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Pars plana vitrectomy (PPV) with various forms of tamponade and retinopexy is often the primary treatment for retinal detachment. However, a rare but serious complication is sterile keratolysis. We therefore aimed to evaluate the prevalence and potential risk factors for the development of corneal ulceration following vitreoretinal surgery for retinal detachment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a single-centre retrospective study including 14 cases of patients presenting to our department with sterile keratolysis involving the stroma after one or more PPVs for retinal detachment or vitreous hemorrhage. Time of primary procedure, time of onset of corneal complications, comorbidities, type of tamponade used, use of endophotocoagulation, cryoretinopexy and number of surgeries were recorded. Patients with additional comorbidities confounding a possible correlation were excluded from the case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 14 patients were identified with corneal complications after pars plana vitrectomy for retinal detachment. Multiple vitrectomies were performed in 86% (12\/14) of the cases. Surgical treatment consisted of six (43%) perforating keratoplasties and seven (50%) amniotic membrane keratoplasties in all but one patient. At an average of three months after the onset of corneal symptoms, the first corneal surgery was performed. Repeated corneal surgery was required in 4 patients (29%) and consisted of two penetrating keratoplasties and four amniotic membrane transplantation. Visual acuity at the first presentation of corneal complications was reduced (2.1\u2009\u00b1\u20090.6\u00a0logMAR), but was not statistically different from the visual acuity at baseline (1.6\u2009\u00b1\u20090.7\u00a0logMAR). At the last follow-up, visual acuity remained reduced at 1.8\u2009\u00b1\u20090.8\u00a0logMAR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The risk of sterile keratolysis seems to increase with excessive laser or cryo-retinopexy, use of silicone oil and repeated procedures. The initial vitrectomy was a complex surgery in all cases and required a longer operating time. Ciliary nerve damage of neurotrophic origin may be the cause of sterile keratolysis, and controlled retinopexy sparing the long ciliary nerves and avoiding cryotherapy may reduce the risk. Controlled studies are needed to investigate the causality between vitreoretinal surgery and sterile keratolysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10792-025-03532-3","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T08:09:21Z","timestamp":1746691761000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sterile keratolysis following pars plana vitrectomy for retinal detachment"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9433-3292","authenticated-orcid":false,"given":"Anna","family":"Hillenmayer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian M.","family":"Wertheimer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstathios","family":"Vounotrypidis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melih","family":"Parlak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"issue":"6","key":"3532_CR1","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1111\/aos.14380","volume":"98","author":"BR Nielsen","year":"2020","unstructured":"Nielsen BR, Alberti M, Bjerrum SS, la Cour M (2020) The incidence of rhegmatogenous retinal detachment is increasing. Acta Ophthalmol 98(6):603\u2013606. https:\/\/doi.org\/10.1111\/aos.14380","journal-title":"Acta Ophthalmol"},{"issue":"8","key":"3532_CR2","doi-asserted-by":"publisher","first-page":"2431","DOI":"10.1007\/s00417-024-06392-2","volume":"262","author":"AS Alfaar","year":"2024","unstructured":"Alfaar AS, Wiedemann P, Rehak M, Wolf A (2024) The rising tide of rhegmatogenous retinal detachment in Germany: a nationwide analysis of the incidence, from 2005 to 2021. Graefe\u2019s Arch Clin Exp Ophthalmol 262(8):2431\u20132438. https:\/\/doi.org\/10.1007\/s00417-024-06392-2","journal-title":"Graefe\u2019s Arch Clin Exp Ophthalmol"},{"issue":"4","key":"3532_CR3","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1097\/ICB.0000000000000832","volume":"15","author":"RA Kurt","year":"2021","unstructured":"Kurt RA, Sonmez B, Kapran Z (2021) Neurotrophic keratopathy after retinal detachment surgery combined with Endolaser photocoagulation. Retin Cases Brief Rep 15(4):479\u2013481. https:\/\/doi.org\/10.1097\/ICB.0000000000000832","journal-title":"Retin Cases Brief Rep"},{"issue":"1","key":"3532_CR4","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1097\/IAE.0000000000000657","volume":"36","author":"HF Chen","year":"2016","unstructured":"Chen HF, Yeung L, Yang KJ, Sun CC (2016) Persistent corneal epithelial defect after pars Plana vitrectomy. Retina 36(1):148\u2013155. https:\/\/doi.org\/10.1097\/IAE.0000000000000657","journal-title":"Retina"},{"issue":"6","key":"3532_CR5","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1001\/jamaophthalmol.2014.280","volume":"132","author":"PJ Banerjee","year":"2014","unstructured":"Banerjee PJ, Chandra A, Sullivan PM, Charteris DG (2014) Neurotrophic corneal ulceration after retinal detachment surgery with retinectomy and endolaser: a case series. 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Korean J Ophthalmol 35(4):255\u2013260. https:\/\/doi.org\/10.3341\/kjo.2021.0048","journal-title":"Korean J Ophthalmol"},{"issue":"2","key":"3532_CR8","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1159\/000310129","volume":"201","author":"U Menchini","year":"1990","unstructured":"Menchini U, Scialdone A, Pietroni C, Carones F, Brancato R (1990) Argon versus krypton panretinal photocoagulation side effects on the anterior segment. Ophthalmologica 201(2):66\u201370. https:\/\/doi.org\/10.1159\/000310129","journal-title":"Ophthalmologica"},{"key":"3532_CR9","first-page":"377","volume":"9","author":"K Green","year":"1992","unstructured":"Green K, Cheeks L, Stewart DA, Trask D (1992) Role of toxic ingredients in silicone oils in the induction of increased corneal endothelial permeability. 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Eur J Ophthalmol. https:\/\/doi.org\/10.1177\/11206721241228005","journal-title":"Eur J Ophthalmol"}],"container-title":["International Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-025-03532-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10792-025-03532-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10792-025-03532-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:04:29Z","timestamp":1766167469000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10792-025-03532-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,8]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3532"],"URL":"https:\/\/doi.org\/10.1007\/s10792-025-03532-3","relation":{},"ISSN":["1573-2630"],"issn-type":[{"type":"electronic","value":"1573-2630"}],"subject":[],"published":{"date-parts":[[2025,5,8]]},"assertion":[{"value":"4 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript. Anna Hillenmayer received speaker fees from Bayer and Novartis. Melih Parlak and Efstathios Vounotrpyidis received speaker fees from Bayer and Novartis. Prof. Dr. Armin Wolf received research grants and study fees from Allergan, Boehringer Ingelheim, Bayer, Alimera, Novartis, Oertli and Roche and consulting honoraria and travel fees from Alimera, Allergan, Bayer, Boehringer Ingelheim, Novartis, Oertli, Roche and Zeiss. For the remaining authors none conflict of interests or fundings were declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the University of Ulm (441\/2023). The authors confirm that the ethical guidelines of the journal were adhered to and that approval was obtained from the appropriate ethics committee. Verbal informed consent was obtained from the participants and approved by the Ethics Committee. In addition, written consent for publication of identifying information and accompanying images was obtained from the participating patient for the single case example.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Written consent was obtained from all participants.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images in Figs.\u00a0\n                      \n                      and\n                      \n                      .","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}],"article-number":"179"}}